Pathology and Clinical Laboratory Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
Breast Cancer. 2011 Jan;18(1):24-32. doi: 10.1007/s12282-010-0222-9. Epub 2010 Sep 23.
To reveal the rate of complete therapeutic effect of radiofrequency ablation (RFA) and its correlation with tumor size by the histopathological examination of surgically resected early breast cancers.
For 28 patients who received RFA and subsequent surgical therapies for early breast cancer treatment, the effect of RFA was evaluated by both histopathological examination and nicotinamide adenine dinucleotide (NADH)-diaphorase staining of resected tumor specimens according to the criteria described by Seki et al. (this issue). The correlation of 100% RFA effect with tumor parameters including tumor size and the presence of extensive intraductal component (EIC) was examined.
The mean size and invasive size of the primary tumors were 2.21 cm (ranging from 0.6 to 5.0 cm) and 1.44 cm (ranging from 0 to 5.0 cm), respectively. By examining hematoxylin-eosin (HE) sections, the effectiveness of RFA was found to be 100% in 16 tumors (57%). However, the effectiveness of RFA was found to be 100% in 22 cases (79%) examined by NADH-diaphorase staining of frozen sections containing part of tumorous and nontumorous tissues. The accuracy of diagnosis of complete RFA effect using NADH-diaphorase staining with reference to HE was 79% (22 of 28) with 100% (16 of 16) sensitivity and 50% (6 of 12) specificity. The rate of 100% RFA effect by HE examination was higher in EIC(-) tumors (13 of 17, 76%) than in EIC(+) tumors (1 of 9, 11%) (P = 0.0022), and was higher in tumors of ≤ 1.5 cm (10 of 11, 91%) than in tumors of >1.5 cm (6 of 17, 35%; P = 0.0034). All five tumors of ≤ 1.0 cm showed 100% RFA effect, but 3 (27%) of 11 tumors of >1.0 and ≤ 2.0 cm and 9 (75%) of 12 tumors of > 2.0 cm showed suboptimal RFA effect by HE.
Tumor size of ≤ 1.5 cm, strictly ≤ 1.0 cm, could be an indication for RFA if a complete histological therapeutic effect is mandatory.
通过对手术切除的早期乳腺癌标本进行组织病理学检查和烟酰胺腺嘌呤二核苷酸（NADH）-黄递酶染色，揭示射频消融（RFA）的完全治疗效果率及其与肿瘤大小的相关性。
对 28 例接受 RFA 及后续手术治疗的早期乳腺癌患者，根据 Seki 等人（本期）描述的标准，通过组织病理学检查和切除肿瘤标本的 NADH-黄递酶染色来评估 RFA 的效果。检查了 100%RFA 效果与肿瘤参数（包括肿瘤大小和广泛的管内成分（EIC）的存在）的相关性。
原发性肿瘤的平均大小和侵袭性大小分别为 2.21cm（范围 0.6-5.0cm）和 1.44cm（范围 0-5.0cm）。通过检查苏木精-伊红（HE）切片，发现 16 个肿瘤（57%）的 RFA 效果达到 100%。然而，通过对包含部分肿瘤和非肿瘤组织的冷冻切片进行 NADH-黄递酶染色，发现 22 例（79%）的 RFA 效果达到 100%。使用 NADH-黄递酶染色参考 HE 对完全 RFA 效果进行诊断的准确率为 79%（28 例中有 22 例），敏感性为 100%（16 例中有 16 例），特异性为 50%（12 例中有 6 例）。在 EIC（-）肿瘤（17 例中的 13 例，76%）中，HE 检查的 100%RFA 效果率高于 EIC（+）肿瘤（9 例中的 1 例，11%）（P=0.0022），在肿瘤直径≤1.5cm（11 例中的 10 例，91%）的肿瘤中高于肿瘤直径>1.5cm（17 例中的 6 例，35%；P=0.0034）。所有 5 个直径≤1.0cm 的肿瘤均显示 100%RFA 效果，但 3 个（27%）直径>1.0cm 且≤2.0cm 的肿瘤和 9 个（75%）直径>2.0cm 的肿瘤的 HE 显示 RFA 效果不佳。
如果需要完全的组织学治疗效果，肿瘤直径≤1.5cm，严格≤1.0cm 可能是 RFA 的指征。
